The Oregon Department of Consumer and Business Services issued COVID-19 emergency orders for multiple lines of insurance. The orders provide protection to people and businesses struggling because of the disruptions caused by the COVID-19 outbreak.

The first order was issued on March 25, 2020. It required all insurance companies to postpone policy cancellations and nonrenewals, extend grace periods for premium payments, and extend deadlines for reporting claims.

Postponement of policy cancellations and nonrenewals is not limited to nonpayment. This provides protection to some people and businesses in need of relief and ongoing insurance coverage.

The second order was issued on May 5, 2020. It applies to health insurers and requires at least a 60-day grace period to pay past due premiums, pay claims for any covered services during the first 30 days of the grace period, and extends deadlines for reporting claims and other communications.

Additional orders were issued on May 23, 2020. Those orders apply to property and casualty, long-term care, and life and disability insurers. These orders require insurers to provide at least a 60-day grace period to pay past due premiums, pay claims that occur during the first 30 days of the grace period, and extend deadlines for reporting claims and other communications.

The Division of Financial Regulation is sharing the frequently asked questions it has received to help insurers comply with the department’s orders. The FAQs will be updated regularly.

The division encourages insurers or other stakeholders to submit more questions about the order by email to dfr.policyteam@oregon.gov.

General questions

These questions apply to the emergency order that was issued on March 25. The orders issued on health, property and casualty, long-term care, and life and disability insurance supersede the March 25 order.

No. If an insured requests cancellation or nonrenewal, the insurer should follow the insured’s direction. The order prohibits insurers from canceling or nonrenewing policies without the consent of the insured for the duration of the order.​​​

The order prohibits many types of cancellations and nonrenewals for the duration of the order. However, some cancellations and nonrenewals may be appropriate and permitted. Therefore, the department will exercise enforcement discretion now and after the order expires if an insurer cancels or nonrenews a policy for certain reasons. While the order is in place, an insurer may cancel or nonrenew a policy for the following reasons:

Voluntary or requested cancellation or nonrenewal

Fraud or intentional misrepresentation of a material fact as prohibited by the terms of an insurance policy

Criminal conduct as prohibited by the terms of an insurance policy

Cancellation during the first 60 days of a property and casualty policy, during which the insurer is underwriting the policy, as long as a minimum 10-day notice is provided

A notice of the cancellation or nonrenewal was issued before the governor’s Executive Order 20-07 (March 17, 2020), in compliance with all applicable laws and administrative rules

The insurer has obtained evidence that the insured secured new coverage with another insurer

Cancellation or nonrenewal is required by applicable state or federal law.

Section 12(a) of the order prohibits all involuntary cancellations while it is in effect. Section 12(e) applies after the order expires. It prohibits insurers from canceling a policy due to claims related to the effect of the outbreak, except in instances of fraud or intentional misrepresentation.​​​

No, it requires insurers to take all practicable steps to make reporting and communication methods available that are compatible with social distancing recommendations. It does not require insurers to adopt all possible methods for all forms of reporting and communication. For example, it does not require insurers to accept claims submitted solely by telephone call, without supporting documentation that may be necessary to substantiate the claim.​​​

Premium finance companies are encouraged to provide a 30-day grace period for payments and take other reasonable actions to help customers affected by COVID-19. Any notice given by a premium finance company should be consistent with state requirements and with the terms of the agreement.

In order to encourage insurance coverage for consumers, premium finance companies should not pursue any default actions for the duration of the outbreak.​​​

The department expects insurers to immediately undertake good faith efforts to comply with the order. It will exercise appropriate discretion in enforcement, understanding that it may take time for companies to achieve full compliance. The department encourages insurers to contact them if full compliance is unexpectedly delayed.​​

The department released the order to provide Oregon consumers and businesses with immediate relief. The department may take more action in response to any federal action affecting the order as appropriate.​​​

The order applies to all policies of health insurance in Oregon, with the
exception of accidental death and dismemberment, disability, and long-term
care polices. This includes all fully-insured commercial health insurance policies,
including individual and group health benefit plans, limited benefit, short-term
limited-duration, and Medicare Supplement policies. However, to the extent
that federal requirements for Medicare Supplement plans conflict with the order,
federal requirements supersede the order.

The order does not apply to self-insured employer plans. However, the division
strongly encourages self-insured employers to take steps to provide similar
relief and flexibility to employee benefit plan members.

With the exception of qualified health plans purchased with tax credits through
the Health Insurance Marketplace (see next question), health insurance policies
that were in a grace period as of the March 25 order must be provided a grace
period of at least 60 total days. For example, if a policy was provided a 30-day
grace period ending March 31, the grace period for that policy must be extended
by at least 30 days to provide a total of 60 days.

Yes. For example, if a policy enters the grace period April 1, and by the
end of 60 days, only one month’s premium has been paid, the policy may be terminated.
However, the cancellation may not be retroactive to a date earlier than the
last day of the first month of the grace period.

If the insurer does not receive the required premium payment by the end of
the 60-day grace period, the insurer may terminate the policy as of the last
day of the first month of the grace period, and may deny claims for services
provided after that date.

Patients may be eligible for other coverage to help cover these claims, including
the Oregon Health Plan or coverage through the Oregon Health Insurance Marketplace,
where they may be eligible for financial assistance. The division strongly
encourages businesses and people struggling to pay premiums to consider all
their options and seek expert assistance from a licensed insurance agent, if
appropriate.

Yes. The division expects insurers to provide comparable flexibility for health
care providers submitting claims or other communications on behalf of insureds.

The division also expects health insurers to provide appropriate flexibility
to health care providers in situations where claims submissions may be delayed
or affected by uncertainty about the patient’s health insurance coverage, since
many people may be transitioning between sources of health coverage at this
time.

Consistent with that guidance, insurers offering health benefit plans should
consider group size only at the time of renewal. These insurers may not cancel
a group health benefit plan policy based on a change in the number of employees
during a contract year.

At the time of renewal, the insurer may review the number of people employed
over the preceding year to assign the group to the appropriate market, consistent
with the division’s guidance on employee counting.

Insurers offering health benefit plans are also reminded, even if an employer’s
market size has changed, the employer is still entitled to guaranteed issue
in the small or large employer market. Accordingly, the insurer must still
offer to renew the employer onto any plans the insurer offers in the appropriate
market.

No, it requires insurers to take all practicable steps to make reporting and
communication methods available that are compatible with physical distancing
recommendations. It does not require insurers to adopt all possible methods for
all forms of reporting and communication. For example, it does not require insurers
to accept claims submitted solely by telephone call, without supporting documentation
that may be necessary to substantiate the claim.​​

The long-term care insurance order applies to all long-term care policies
issued in Oregon. Long-term care policies help cover the cost of nursing home,
assisted living, or home health care for people unable to perform activities
of daily living, such as bathing and dressing.

The life and disability order applies to all types of both life and disability
insurance issued in Oregon, except for annuities.

Examples of life insurance includes term, whole, universal, mortgage term,
and final expenses. Examples of disability insurance includes both long- and
short-term, mortgage, and supplemental. Disability policies cover you if you
cannot work because you are sick or injured for an extended period of time.

The four emergency orders for specific types of insurance supersede the original
emergency order issued March 25 for all lines of insurance.

Unless otherwise specified, the emergency order issued March 25, and extended
until June 22, applies to all other lines of insurance that do not fall under
one of the four specific emergency orders.

This emergency order requires all insurance companies issuing policies not covered
by one of the specific emergency orders to postpone policy cancellations and
nonrenewals, extend grace periods for premium payments, and extend deadlines
for reporting claims.

​​Each insurance emergency order has a minimum grace period as well as a minimum length of time claims will be covered. Insurance companies can provide longer grace periods and coverage windows if they want. This chart details each type of insurance and its minimum grace periods and coverage window.

Yes. The division expects insurers to provide comparable flexibility for third-parties,
such as health care providers, body shops, and contractors when submitting
claims or other communications on behalf of policyholders.

No. The orders require insurance companies to take all practicable steps to
make reporting and communication methods available that are compatible with
physical distancing recommendations.

However, the orders do not require insurance companies to adopt all possible
methods for all forms of reporting and communication. For example, the orders
do not require insurers to accept claims submitted solely by telephone call,
without supporting documentation that may be necessary to substantiate the
claims.​​